Pathological formations that developed for no apparent reason through cell reproduction. They differ in polymorphism of the structure and isolation of growth. True tumors have a number of features that distinguish them from entities that are similar in appearance. So, they should be distinguished from swelling, which is a symptom of diseases such as cysts, goiter, etc., are also with hematomas, dropsy, various inflammatory processes and injuries.
Reactive swelling of the tissues of the body after elimination of the causes disappears. The development of the tumor that has begun always continues, as it were, getting out of the regulatory action of the body, as it has “autonomy” of growth.
Tumor qualities can occur in the cells of any body tissues capable of reproduction. Having become a tumor, the original cell transfers new properties to its direct cellular descendants, which become similar to it in their morphological and chemical characteristics, a manifestation of a number of patterns.
According to the characteristics of growth and clinical course, benign and malignant tumors are distinguished.
Benign tumors grow slowly, are surrounded by a capsule, do not germinate, but spread adjacent tissues and organs. Depending on the localization, such a tumor in some cases may exist throughout the life of the patient, without causing him much harm. In other cases, with its growth, it puts pressure on the nearby organ, causes its atrophy, squeezing the vessels and nerves. A benign tumor does not give metastases and after its radical removal, a cure occurs (does not recur).
Malignant tumors are characterized by rapid infiltrating growth, they are not delimited from neighboring tissues by the capsule and, germinating, destroy them.
The cells of malignant tumors, growing into the lymphatic and blood vessels, can come off and be transferred to other organs by the flow of fluid (blood, lymph), causing the development of new tumors - metastases. The growth of a cancerous tumor in the body changes the metabolism, causing a deterioration in general condition, a sharp depletion and degeneration. The onset of its development is often asymptomatic, which leads to late treatment of patients and delayed diagnosis. The infiltrating ability to spread creates difficulties in establishing the boundaries of the lesion, which causes the need to remove during the operation not only the tumor, but also the surrounding healthy tissues, which may contain cancer cells. However, even after that, relapse may again occur in the same place.
The separation of tumors into benign and malignant is conditional and permissible only with a clinical assessment of the disease. Since benign, but located near vital organs and violating their function, can lead to the death of the patient (brain tumor, mediastinum, etc.).
Examination of a patient with a suspected tumor should answer first of all the following questions: 1) if there is a true patient or the formation taken for it is a symptom of another disease; 2) a benign or malignant tumor, whether there are metastases; 3) is it possible to remove the tumor, i.e. whether there is technical (anatomical) and functional operability. The answers to these questions are obtained after a detailed clarification of complaints, the history of the disease and clinical, endoscopic, radiological, pathophysiological and other special examination methods.
Symptoms and course:Benign tumors usually do not cause complaints and are often detected by chance, on the internal organs they appear only as symptoms of a mechanical disturbance in their activity. The general condition of the patient, as a rule, does not suffer. When examining a superficially located formation, the roundness of its shape or lobation of the structure attracts attention. The tumor is mobile, not fused with the surrounding tissues, its consistency may be different, regional lymph nodes are unexpanded, and palpation is painless.
The onset of the development of a malignant tumor proceeds hidden for the patient himself, and yet early diagnosis is important. In this regard, when examining people, especially over 35 years of age, about oncological alertness should be manifested for no apparent reason about vague complaints, the onset of weight loss, long-term continuous and growing symptoms of the disease. This concept includes: 1) suspected cancer, 2) a thorough history taking, 3) the use of general and special research methods; 4) in-depth analysis and generalization of the materials obtained for the diagnosis.
Often, patients with a malignant neoplasm complain of a violation of the general condition: loss of normal tonus at work, apathy, lack of appetite, nausea in the morning, weight loss, etc. More local signs can also join this - the presence of a chronic disease of the stomach, rectum, and the appearance of compaction in the mammary gland and others. At first, these phenomena may not be accompanied by pain, but then, when the tumor begins to grow into nerve trunks, pain appears, assuming an increasingly painful character. The cancerous tumor grows rapidly. Substances for the nutrition of cells come from the whole body, causing their lack in other tissues and organs. In addition, despite the large number of blood vessels in a cancerous tumor, their inferiority often leads to malnutrition in its individual areas and their decay. The products of necrosis are absorbed into the body, lead to intoxication, progressive emaciation, exhaustion, cachexia.
Recognition:A history of attention is drawn to chronic diseases, the profession of the patient, bad habits. After a general examination of the patient, feel the size of the tumor (if available), its nature, consistency and attitude to the surrounding tissues. The presence of ulceration, distant metastases, and an increase in regional lymph nodes are determined.
When examining hollow organs (intestines, gall bladder, etc.), endoscopy is widely used, which is performed by endofibroscopes with an optical system and lighting. It makes it possible not only to examine a suspicious organ site, "o and take a piece for histological examination. Biopsy (excision) followed by microscopic examination is a very valuable method of oncological diagnosis. In case of internal organs disease, when, despite all the applied research methods, the diagnosis of the disease remains unclear, and the suspicion of a tumor process is not removed, they resort to a diagnostic operation (gluttony, thoracomy, etc.) to determine the nature or extent of spread Processes.
Prevention:It has now been established that part of the tumors develops on the basis of a variety of long-term inflammatory and other diseases of the organs. For example, with chronic anacid gastritis, chronic callous ulcer and polyps of the stomach, stomach cancer can develop over time. Chronic bronchitis and prolonged recurrent interstitial pneumonia precede lung cancer. Long-term non-healing cracks and ulcers, increasing age spots, growing warts, papillomas and hyperkeratoses precede skin cancer. All this made it possible to create a doctrine of precancerous, precancerous diseases, the detection and treatment of which is the basis of cancer prevention.
Surgical treatment of a benign tumor: excision with a capsule followed by histological examination. With small and superficially located, not disturbing the patient, waiting is possible. Absolute indications for its removal are: 1) the presence of a symptom of compression of the organ, obstruction, the cause of which is a neoplasm; 2) permanent trauma to clothing with a superficial tumor; 3) growth acceleration and suspicion of malignant degeneration.
The treatment of malignant tumors depends on the stage of development of the disease. The formed tumor growth site is initially limited to an organ or tissue, but subsequently, due to germination into the surrounding tissues and metastasis of tumor cells, a generalization of the process occurs. In this regard, there are four stages of the development of the disease: stage 1 - a localized process; Stage II - damage to nearby (organ) lymph nodes; Stage III - damage to the regional lymph nodes; Stage IV - the presence of distant metastases.
Malignant tumors are subject to immediate radical surgical treatment. The operation consists in the complete or partial excision of a tissue or organ along with a developed tumor and fiber with regional lymph nodes.
However, the opportunity to perform such a radical operation appears only in patients with stages 1 and II of the development of the process, less often in patients with stage III due to the presence of distant metastases and their germination in vital organs.
In recent years, the surgical method has been widely combined with x-ray and radium radiation, with hormone therapy. They began to apply chemical and biological methods of treatment.
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